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Minimally Invasive Robotic Repair - Heller Myotomy


The esophagus is the tube that carries food from the throat to the stomach. The lower esophageal sphincter (LES) is a muscular ring that closes off the esophagus from the stomach. Achalasia is a rare disorder of the esophagus. If you have achalasia, your LES fails to open up during swallowing, which is supposed to do. This leads to a backup of food within your esophagus.
There is no cure for achalasia, but it can be managed with treatment and medical therapy. Surgery may also be a treatment option for younger patients.
Causes of Achalasia
The cause of achalasia is unknown. There are various theories varying from infection, genetic factors, as well as disorders of the immune system that damage the esophagus (autoimmune disease).

Symptoms of Achalasia
Achalasia usually develops slowly with the symptoms getting worse as time progresses. Some noticeable symptoms of achalasia include:
• Difficulty swallowing
• Mild, recurring chest pain
• Significant weight loss
• Regurgitation (bringing swallowed food up again to the mouth)

Diagnosis of Achalasia
Patients with achalasia have an increased risk of esophageal cancer. The condition is rare, but it is important to confirm or rule out the diagnosis when having difficulty swallowing. If a patient is diagnosed with achalasia, they can start taking measures to prevent esophageal cancer.
Since the condition is so rare, physicians do not always think to check for it, so be sure to speak up if you have a family history with the disease or think you have matching symptoms.
Your doctor will most likely perform a physical exam, ask about your symptoms, and ask about your risk factors, among others items. After that, you may have:
Diagnostic tests and procedures
• X-rays (barium swallow test)
• Esophageal manometry test
• Endoscopy
Treatment of Achalasia
Since achalasia cannot yet be cured, treatment focuses on finding ways to help the esophagus relax. This usually involves removing any obstructions that get in the way. There are several ways to accomplish this, and many of them are nonsurgical.
Lifestyle changes
• Dietary changes may help people manage their achalasia.
• Patients may also benefit from chewing food thoroughly, eating slowly, and drinking liquids with meals.
• Some medications can help relax the lower esophageal sphincter and include:
o Nitrates will help relax the muscle and used to relieve symptoms.
o Calcium channel blockers will help relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.
Medical and Surgical procedures
• Pneumatic dilation
• Heller myotomy
• Fundoplication
We are here for you with our multidisciplinary teams comprised of thoracic surgeons, cardiothoracic anesthesiologists, pulmonologists, and gastroenterologists; alongside our dedicated team of nurses, technicians, pharmacists, and staff are skilled in all aspects of health care. Our teams are able to deliver comprehensive, compassionate care that uses evidence-based guidelines, as well as leading-edge noninvasive, invasive, diagnostic, and therapeutic techniques and therapies. To learn more about all of our services, please visit “RWJBH Heart, Vascular, & Thoracic.”

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